The overall aim of this investigation is to determine family process correlates of mental health problems in children who are at risk due to chronic mental illness. A model will be tested whereby family routines and family beliefs are proposed to serve a protective function for children with asthma. An alternative model will be tested whereby parent psychological distress is proposed to have a direct influence on family routines, beliefs, and child mental health. The sample under investigation will include 225 children who have been diagnosed with asthma that includes daily disease management. It is being proposed that the enactment of family routines and the creation of coherent beliefs about illness can protect children from developing internalizing (anxiety and depression) and externalizing symptomatology. A model will be tested whereby family routines and beliefs are proposed to be related to child mental health through their effects on medical adherence and family health.. Multi-group comparisons will be made to evaluate the moderating effects of illness severity, family life stress, and child gender. A targeted sub-sample will participate in a longitudinal study aimed at detecting variability in routines and medical adherence in relation to child mental health Results from this study will inform, prevention efforts aimed at reducing psychological distress in children with chronic medical illnesses such as asthma, diabetes, and cystic fibrosis.